West Virginia Code of State Rules
Agency 78 - Human Services
Title 78 - LEGISLATIVE RULE DEPARTMENT OF HUMAN SERVICES BUREAU FOR SOCIAL SERVICES
Series 78-03 - Minimum Licensing Requirements for Residential Child Care and Treatment Facilities for Children and Transitioning Adults and Vulnerable and Transitioning Youth Group Homes and Programs in West Virginia
Section 78-3-21 - Program-specific Rules for Maternity and Parenting Facilities
Universal Citation: 78 WV Code of State Rules 78-3-21
Current through Register Vol. XLI, No. 38, September 20, 2024
21.1. Maternity Care.
Care to a pregnant or parenting adolescent or transitioning adult includes, but is not limited to:
21.1.1. Appropriate health care and health
education;
21.1.2. Education needs
specific to the pregnant or parenting youth;
21.1.3. Nutritional guidance and
support;
21.1.4. Counseling
services specific to making decisions and planning for his or her
child;
21.1.5. Parenting
educational services; and
21.1.6.
Maintenance of an environment conducive to the safety of children (infant
through toddler) and pregnant women.
21.2. Appropriate Health Care and Health Education.
21.2.1. The organization shall
provide or arrange for health services to the expectant and parenting youth
that includes:
21.2.1.a. A written health
summary, including family medical history, immunizations, surgical procedures,
and childhood illnesses;
21.2.1.b.
A general medical examination that will occur at the time of admission, and an
obstetrical/gynecological examination for the pregnant youth within the first
two weeks of admission or sooner if the youth is considered to be high
risk;
21.2.1.c. Thorough medical
supervision of the pregnancy, including all needed prenatal care; testing and
post-natal care shall be done by an appropriately licensed health care
professional with a specialization in women's health; and
21.2.1.d. Direct provision or referral for
services to meet the needs of high-risk pregnancy or high-risk infant
care-related issues.
21.2.2. Registered nursing employees with
obstetrical/gynecological experience are to be available on the grounds at
least 12 hours per day, with 24-hour availability onsite.
21.2.3. The pregnant or parenting youth shall
receive ongoing health education with age-appropriate instruction regarding
pregnancy prevention, HIV/AIDS prevention, and general information about the
prevention and treatment of disease.
21.2.4. The organization shall be located
within 15 minutes of a hospital or birthing center that provides maternity care
and labor and delivery services.
21.2.5. Standing medical orders for pregnant
youth shall be carefully evaluated and shall take into consideration cautions
necessary for pregnant youth.
21.2.6. All pregnant or parenting youth shall
have access to educational services as appropriate:
21.2.6.a. All pregnant or parenting youth,
once assessed, shall participate in some type of educational service such as
GED classes, public school, or alternative education;
21.2.6.b. Child care services shall be in
close proximity to the education facilities; and
21.2.6.c. Supportive services for child care
shall be available to assure that the youth can have necessary study
time.
21.3. Nutritional Guidance and Support.
21.3.1. All
parenting and pregnant youth will be assessed at a minimum within the first 30
days of admission by a registered dietitian unless dietary problems are
indicated at admission.
21.3.2.
Ongoing dietary support shall be encouraged through a nutritional education
program and if indicated by individual instruction provided by the registered
dietitian or registered nurse.
21.3.3. All pregnant and parenting youth
shall receive counseling services specific to parenting and alternative
choices, on an ongoing basis.
21.3.4. The organization shall have policy
and procedures related to the involvement of the putative father of the
baby.
21.3.5. Supportive counseling
services will be extended to the family of the young woman, the biological
father (unless contra-indicated by court order) and the family of the
biological father.
21.3.6. The
organization shall offer an ongoing parent education program with a curriculum
that comprehensively addresses at a minimum, the following topics:
21.3.6.a. Personal growth and
maturity;
21.3.6.b. Interpersonal
relationships;
21.3.6.c. Early
childhood development;
21.3.6.d.
Infant stimulation, cognitive development, and bonding/attachment;
21.3.6.e. Safety and accident prevention,
including First Aid and CPR;
21.3.6.f. Physical care, nutrition, and
health of infants and young children;
21.3.6.g. Signs and symptoms of child abuse
and neglect;
21.3.6.h. Time,
budget, and household management;
21.3.6.i. Community resources that provide
assistance; and
21.3.6.j. Child
care use and how to choose providers.
21.3.7. Parenting education may be offered in
both a formal and informal setting using classroom instruction, small groups,
and individual and experiential teaching methods, based on the needs of the
youth.
21.3.8. The organization
shall maintain an environment conducive to the safety of a child (infant
through toddler) and a pregnant or parenting youth.
21.3.9. The facility shall contain at least
one area for routine medical examination, counseling, and treatment for
clients. This area shall be private and in adherence with all universal
precautions, Occupational Safety and Health Administration (OSHA) standards and
best medical practice.
21.3.10. All
living areas shall be maintained in good repair and meet the Child Product
Safety Commission (CPSC) guidelines.
21.3.11. The exposure of the pregnant teen
and infant to cleaning supplies and pesticides should be limited. The
organization shall be cognizant of the possible side effects of exposure and
limit it accordingly.
21.4. Baby Care.
21.4.1. An organization shall provide a plan
of care for babies that includes, but is not limited to the following:
21.4.1.a. Appropriate health care;
21.4.1.b. Appropriate daily care;
and
21.4.1.c. Appropriate daily
stimulation.
21.4.2. An
organization shall also provide:
21.4.2.a. A
warm and child friendly environment; and
21.4.2.b. Employees specifically trained to
meet the needs of infants through toddlers.
21.4.3. The organization shall document that
all babies receive a thorough assessment prior to leaving the hospital or at
the time of admission to the organization.
21.4.4. The organization shall assure that
all children receive health care according to the Early Periodic Screening,
Diagnosis and Treatment Program (EPSDT) standards of care.
21.4.5. The organization shall have policy
and procedures to assure that the health and well-being of the child is
protected once he or she leaves the hospital.
21.4.6. The organization shall have policy
and procedures to assess and treat babies and children who show signs of
illness that include but are not limited to diarrhea, vomiting, fever,
etc.
21.4.7. If at any time the
baby's mother is unable or refuses to care for her baby, the organization shall
have policy and procedures to assure that appropriate interventions are used to
secure the health of the child.
21.4.8. Appropriate daily care:
21.4.8.a. The organization shall ensure that
all babies have the necessities to meet their basic daily needs.
21.4.8.b. The organization shall ensure the
basic needs of the baby are consistently met;
21.4.8.c. All babies under twelve months of
age shall have a feeding and diet plan prescribed by the physician.
21.4.9. The organization shall
handle breast milk and formula in the following manner:
21.4.9.a. Prepared bottles shall be capped
and clearly labeled with the child's name, contents, and the date
prepared;
21.4.9.b. Prepared
bottles shall be refrigerated in a separate section of the refrigerator and
accessible only to employees;
21.4.9.c. Breast milk shall be stored in
containers specific to the purpose;
21.4.9.d. Breast milk or formula when it
remains at a temperature higher than forty-one (41) degrees Fahrenheit for more
than one hour shall be discarded;
21.4.9.e. Refrigerated breast milk shall be
used within 48 hours of receipt, frozen breast milk within two weeks of receipt
and deep-frozen breast milk within three months of receipt;
21.4.9.f. Formula bottles shall be used
within time frames established by the manufacturer and listed on the package;
and
21.4.9.g. A microwave oven is
not permitted for the heating of breast milk or formula bottles.
21.4.10. Solid food, including
cereals are not to be placed in a bottle unless prescribed by a
physician.
21.4.11. Jar baby food
is to be served from a bowl and not from the jar.
21.4.12. Until a baby is able to hold a
bottle securely, a baby and the bottle shall be held while the baby is being
fed. At no time is the bottle to be propped.
21.4.13. All babies shall receive daily
stimulation to encourage the emotional, physical, and intellectual development
of the child. This includes:
21.4.13.a.
Holding, rocking, and playing whenever possible, including while bathing,
dressing, and carrying the child;
21.4.13.b. Encouraging positive
communications and language development by making eye-to-eye contact with the
child, singing, talking, reacting to the child's sounds, naming objectives,
reading stories, and playing musical games;
21.4.13.c. Paying attention to crying and
meeting the immediate needs of the child;
21.4.13.d. Ensuring that no child is
routinely left in a crib or playpen, except for sleep or rest; and
21.4.13.e. Providing a child who is awake
with play equipment and opportunities to play freely on a clean
floor.
21.4.14. The
organization shall ensure that all products containing potentially hazardous
chemicals, including identified poisons, medications, certain cleaning
supplies, and art supplies not clearly labeled as "nontoxic", are inaccessible
to all children in a locked cabinet away from food, and when possible, stored
in their original containers and never in containers originally designed for
food.
21.4.15. The organization
shall ensure that all electrical outlets within the reach of a child when not
in use are protected by a cover.
21.4.16. The organization shall ensure that
when an electrical appliance is used, an adult is present at all times to
supervise the use of the appliance.
21.4.17. The organization shall provide a
shield to protect a child from hot pipes or radiators and shall not use
unvented fuel fire heaters.
21.4.18. The organization shall ensure that
barriers and gates are appropriately used.
21.4.18.a. All temporary walls or items being
used as physical barriers shall be firmly anchored so that they pose no threat
to the safety of the child.
21.4.18.b. Stairways to which the child has
access shall have appropriate railing and safety gates or other barriers at the
top and at the bottom.
21.4.19. The organization shall ensure that
strings, cords and hanging items are of no threat to the children.
21.4.19.a. The drawstring on clothing such as
on hoods or collars shall be removed or secured to prevent potential risk to
the child.
21.4.19.b. Pacifiers
attached to a string or ribbon that is 6 inches or more in length shall not be
placed around a child's neck or affixed to the child's clothing; and
21.4.19.c. No child is to have access to a
string or cord that is 6 inches or more in length and attached to a fixed
object, such as a window shade, nor access to any other potentially dangerous
hanging item, such as a tablecloth.
21.4.20. The organization shall ensure that
there is an outdoor play area appropriate and safe for young
children.
21.4.21. The organization
shall ensure the safety of the child during transportation. The driver or
qualified employee shall ensure that each child three years of age and under is
secured in an approved child safety seat.
21.4.22. The organization shall ensure that
the overall environment of the children's area of the facility is clean,
pleasant in appearance, well-lighted and conducive to the development of
children.
21.5. Employee Training.
21.5.1. The organization shall
ensure that all employees are specifically trained to meet the needs of the
very young child.
21.5.2. All
employees shall be trained within the first 30 days of employment on basic
infant care. Prior to completion of the training, the new employees shall be
scheduled to work only with fully trained employees.
21.5.3. At a minimum, all employees shall be
trained in:
21.5.3.a. Child
development;
21.5.3.b. Infant CPR
and first aid;
21.5.3.c. Basic
child care;
21.5.3.d. Sick baby
care; and
21.5.3.e. Parenting
skills.
21.6. Children shall be cared for and supervised at the following levels:
21.6.1. A minimum of employee-to-child ratio
of 1-to-6 shall be maintained during waking hours when children are on the
grounds with a minimum of one employee present per residential living unit at
all times when more than one child is present in the living unit;
21.6.2. Additional or back-up care employees
shall be available for emergency situations or to meet special needs presented
by the persons in care; and
21.6.3.
A minimum employee-to-child ratio of 1-to-12 shall be maintained during
sleeping hours with a minimum, of at least one employee per residential living
unit to be awake at all times when children are present in the living
unit.
Disclaimer: These regulations may not be the most recent version. West Virginia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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